Pharmacist - Clinical Pharmacist Advisor Medicare

Job Title: Pharmacist - Clinical Pharmacist Advisor Medicare
Location: Remote, RI 02895
Duration: 6 months+ with possible extension

Pay Rate: $53/hr. on W2
 
Possibility for Full-Time Conversion
Interview: Virtual interviews via Microsoft Teams
 
Client Notes – PLEASE READ CAREFULLY

• Candidates must be on camera during all meetings—including training, team meetings, and supervisor interactions.
• This is a Safety Sensitive role.
• **Client Bill Rate: ***
• **Supplier Bill Rate: ***

 
Do NOT Submit:

• Candidates previously submitted for ramp roles (2023–2024) or rejected by the hiring team.

 
Resume Requirements – Top of Resume MUST Include:

• Internet Speed Test Screenshot from www.speedtest.net showing minimum:
  • 25 Mbps download / 5 Mbps upload.
• Screenshot of Active Pharmacist License in the state of residence showing:
  • Name, State, Active Dates, License Number, etc.

 
Shift Information:

• Business Hours:
  • Monday – Friday: 7:00 AM – 8:00 PM EST
  • Saturday & Sunday: 7:00 AM – 4:30 PM EST
• Training Schedule:
  • First 8–10 weeks, Monday to Friday, 9:00 AM – 5:30 PM EST (No time off allowed).
• After Training:
  • Assigned 8-hour shifts will include one weekend day or a weekend rotation based on business needs.

 
Required Technology Skills:

• Must be computer literate with experience in:
  • Excel
  • Word
  • Access (preferred)
  • PowerPoint (preferred)
  • Visio (preferred)

 
Required Licensure:

• Licensed Registered Pharmacist in the state of residence.
• Must be in good standing.

 
Pre-Submission Candidate Questionnaire (Include answers at top of resume):

• Attendance is extremely important during the first 8–10 weeks. Training runs Monday–Friday, 9:00 AM–5:30 PM EST. Do you have any conflicts with this schedule or time off planned?
• After training, shifts will be assigned based on business needs and may include weekends. Can you work any 8-hour shift between 7 AM–8 PM EST?
• This is a Work From Home position. Do you have a dedicated, quiet, separate workspace?
• Do you have wired internet that meets minimum 25 Mbps download / 5 Mbps upload speed? (Attach screenshot from www.speedtest.net)
• Can you sit and work without interruptions for the entire shift?
• This job involves data entry and using multiple computer applications on dual monitors. Do you have experience with this type of work?
• Do you have an active pharmacist license in good standing in your state of residence? (Attach screenshot)
• Can you work independently in a productivity- and data-driven role?
• This role requires a positive and engaged attitude. Can you bring that to the team?

 
Position Summary:
As a Clinical Pharmacist Advisor – Medicare, you will directly support Medicare Part D members and providers with pharmacy benefit requests. Responsibilities include:

• Ensuring accurate case setup for members.
• Reviewing clinical data to make informed decisions.
• Performing outreach to providers when additional information is needed.
• Making accurate decisions in compliance with Medicare guidelines, compendia, and CMS timelines.
• Promoting a best-in-class member service experience.
• Opportunity for full-time employment contingent on performance.

 
Duties:

• Accurately set up and review Medicare appeals cases.
• Analyze internal notes and faxed information to extract key clinical data.
• Clearly document case activity and contact providers when needed.
• Adhere to Medicare guidelines and CMS-mandated timelines.
• Meet departmental productivity and quality standards.
• Apply clinical knowledge using drug compendia, work instructions, and Medicare guidance.
• Participate in performance reviews and continuous improvement discussions with supervisors.

 
Experience:

• Managed Care or PBM (Pharmacy Benefit Management) experience preferred.

 
Education:

• Bachelor's degree in Pharmacy or Doctor of Pharmacy (PharmD) required.
• Must hold an active pharmacist license in good standing in the state of residence.